Category Archives: Blog

The Pain that doesn’t go away.

First rule out biology -BIO – there are many reasons for pain. Far too many of them are not detected through blood tests or imaging. Too often, we doctors miss the diagnosis. Then by the time the diagnosis is made, the acute pain has become chronic.

Tissue damage, inflammation, nerve damage – they are really hard to treat when there is chronic pain. Especially nerve pain is hard to treat. From the age of thirty, most of us have some form  of osteoarthritis. Unfortunately – the only treatment for that is exercise, stretching and surgeries – like back surgery or joint replacements. Surgeries usually help, but they don’t always help.

Once we have exhausted the biological part – we’re stretching, we’re moving, we’re taking the medications that we can, and still there is not relief, then we really have to concentrate on the other areas of pain. BIO-PSYCHO-SOCIAL.

PSYCHO – TRAUMA – physical trauma, illness, environment, toxins and past childhood and adult trauma. Chronic pain is a trauma in itself. It robs you of power.

SOCIAL – Pain makes it almost impossible to use your energy to spend time with others. There is sometimes only enough energy to get through the day. It can cut you off from everyone.

Start with work on the alarm system. It is broken if you have chronic pain. It is very important to recognize that the pain messages you are receiving are false alarms. They do matter! They are causing your pain. But they are causing too much pain for the tissue damage that is present. You can’t trust your pain signal.

Start with making sure you get up every day at the same time. Get dressed, no matter how hard this is. Do your make up if that is what you used to do before you became ill. It is important to make these steps to normal.

I now the breathing. Judy and her bloody breathing. People don’t know how to breathe to lower alarm. Step 2.

I know you want to work. I know you link the work with your self image. And work at least gives you power and social connection. It gives you self respect. Work if that is what you need, but the most important is load! Pacing. If you have chronic pain, you have to take every 20 minutes off for at least 10 minutes to practice breathing and something like super brain yoga. You can do this in the chair. See this and the breathing in LOWER INFLAMMATION


Every 20 minutes – 5-4-3-2-1, superbrain yoga and a deep breath.

Chair yoga 3 times a week. Even if all you do is sit and watch the videos. Eventually do a few movements. Eventually you WILL complete the program. Commit to 3x a week chair yoga.

More to follow


Why is the Shame response so important

Is this JUST anxiety. Oh No! Not Just. Stress and Anxiety affect every part of your life – your biology – inflammation, high blood pressure, high blood sugar, the list goes on and on.  Affects psychology – how you think about yourself. Affects you spiritually – how you see the world and what is perhaps beyond what we see in this world.

Shame is a response to not feeling good enough. How do you see yourself? Do you feel capable? Capable enough? Always consider the word enough. In a broken world with broken systems, we try to compensate for things we have no control over. People pleasers and perfectionists cause themselves enormous stress and body ills. Not just your body. Also affects those around you. Affects communities.

Notice shame responses. Where do you feel it in your body? Are you fiddling more than usual – fingers and hands moving. Foot can’t stop bouncing? How does your gut feel? Are you getting headaches? Is your blood pressure going up? Sweating from too high adrenaline. Hormones are running amuck.

Be curious – Ah. I’m having a shame response.

Next step – calm the limbic system – the alarm center of your brain. I do 5-4-3-2-1 grounding techniques. I am an Olympic breather. Gold medals all around. Super brain yoga takes a minute – all on Lower Inflammation.


Take the time

Take care


Examination and anxiety

Anxiety can stop you from healing. Fear often causes you to not want to try new things. Always speak to your healthcare professional about medications and treatment.

Healing requires learning  tools and accepting many different ways to improve your life. The page, Lower Inflammation, has tools to lower inflammation in the brain and body and by doing that lowering stress. Medications can also be very helpful when you have anxiety.

B Blockers lower the alarm in our flight fight freeze area of the brain – the limbic system. Lowering the alarm slows the body down – they slow the heart rate down. They can raise low blood pressure or can drop high blood pressure – the freeze response causes low blood pressure and the fight, flight response raises blood pressure.

If have asthma, then propranolol is not advised. If you have a pulse of under 50, then also not advised. The B blocker also helps slow your breath. Slow abdominal breaths make a humungous improvement on anxiety.

I see the Limbic system as a second brain. The first brain is our thinking brain. B blockers relax the body which then feeds information to your second brain, the limbic system, and it reads lower alarm and relaxes. When the second brain is not wo aroused, the thinking brain is lit up and can do the work to concentrate and learn new things.

Be careful of new medications. B blockers slow reflexes down, so if you are driving, keep long travelling distance between cars.
Always test new drugs out first – take a small dose when you’re at home.

Selective serotonin re-uptake inhibitors, SSRIs, side effects are many. Especially in the beginning. They can make you more anxious, give you gut upsets, dizziness, whooziness and have other side effects.

Unlike b-blockers, they take a while to work, but the side effects start early. After a week or two, the brain adjusts and then the effects of lowering the alarm center is similar to b blockers.

Unlike the b blockers, they work directly on the nervous system. They improve the thinking part of the brain which then gives feedback to the alarm center – this is called downstread regulation of alarm system –second brain. B blockers relax the body and that regulates the alarm center with upstream regulation.

Body and Brain connected!!

The interesting thing about SSRI’s – there are links to improved brain function structurally – not just operating to help you function better. We know the brain is plastic – neuropasticity – so there is proof that it works to improve brain in the long term.
Long term harms – after years and years – they can cause or increase risk of osteoporosis

In terms of doses in SSRI – low doses cause increased anxiety in the beginning. A prof used to say me, the more side effects you have, the more you need the medication. It’s your body resisting change – typical of anxiety. Go low and go slow, but usually someone with anxiety needs higher doses of SSR than people with depression. Having said that, everyone is different. Listen to body.

The SSRIs take usually 6 to 8 weeks to work. Some people actually feel better after two. I find the people using tools for anxiety actually get better faster and I’ve seen improvements in 2 weeks. B blockers work much faster – within about 30 minutes.

Another long term consequence is that people can feel so regulated with the medication, they ignore the most important part of healing – using every tool you can to eventually be free of medications. If possible. No shame if you need meds.

The meds can, however, help give you the energy and motivation to start using these important ways to heal, like the ones found on the Daily Program and Lowering inflammation (and stress).

Good luck


What is gaslighting?

Today, in the office, I hear a patient explain there are troubles in her relationship. She says “But, I am too sensitive.”

That is a huge red flag that the patient is being gaslighted. 

People pleasers are often attracted to narcissits. When we are hurt in life, we behave sometimes by hurting others, or by hurting ourselves.  Which one are you?

Please take care


Long Covid

Covid is here to stay. The stress of the pandemic, the division it has caused in families and communities, and the near collapse of health care systems are only some of the long term effects. Another is Long Covid after a Covid infection.

Some long Covid symptoms include fatigue and exhaustion with exertion. After a COVID infection, notice your body’s needs. If you feel fatigue, then a gradual return to activities is necessary. Try the 4 P’s:

Pacing, Prioritizing – choosing the most important tasks, Positioning – modifying activities to make them easier to do, Planning to conserve energy.

 Long COVID causes physical and mental changes – anxiety, depression, PTSD. The viral effects can be compared to myalgic encephalitis, ME syndrome.

Shortness of breath can be helped using Breathing Exercises, Lung exercises – see video below. A pulmonary therapist can help assess for the need for medication or oxygen.

Sleep and Relaxation is very important for healing. 

Body exercises and tools cand be used to Lower Inflammation.

People with long Covid can develop POTS, fluctuations in your heart rate depending on your posture. 

We talk so often about medical care, but the care of family, friends, and community is essential. Reach out to your loved ones – don’t be shy to ask for help.

Take care


Why is my pain worse at night?

In the day, our brains are occupied with all the things that need to be done and tasks and people – all the distractions. Look at the red arrow – that is pointed towards your frontal cortex. That is the thinking part of the brain. Where you plan. Where you complete tasks.

At night, that part of the brain is less stimulated. Here it is in blue. The blue shows not much glucose is being used – glucose is the only energy source for the brain. (This brain is a brain of someone with PTSD but it sort of highlights what I’m trying to explain.)

At night the Limbic system is awake. This is the part of the brain responsible for controlling pain. Also sleep. And metabolism and blood pressure and all sorts of things. Now at night, this part of the brain is more active than the cortex.

Also, at night, if you lie there thinking and thinking and thinking (that’s anxiety) then the flight fright fight center (Limbic system) is stimulated. See the yellow? That is the area of pain and inflammation.

Obviously, it’s a bit more complicated than that. Everyone is different. General explanation. Have a look at this section to Lower Inflammation and pain. 

Take care


Not so happy holidays

Holidays often remind us of what we have missed, lost loved ones, or being alone.

Today I worked on my Anxiety and Depression page while I thought about those of you who are struggling in a world filled with positive and negative events.

Take care.



When we talk about stress, we talk about the physical and environment and social and mental.

Stressors can be chronic pain, infections, extreme cold, extreme heat, dehydration, poor diet, smoking, alcohol, too little exercise, too much exercise, too happy, too upset, too much work, too little work, too much responsibility or only thinking about yourself. You get the idea.

It’s too easy to blame emotions. These upsets affect the limbic system and contribute to chronic diseases and mental illness.

Take care over the holidays.


Chronic Exertional Compartment Syndrome

Chronic Exertional Compartment Syndrome CECS this can cause pain in your legs, or your arms, or even your abdomen when you exert yourself. Overexercising can cause swelling in limbs and then pressure on arteries. This can then slows the flow of blood and the muscles become painful.

Here is a great link from Mayo Clinic. CECS.

The diagnosis is difficult as you need to be exercising, then have the symptom, and then immediately have pressure tests done, usually like blood pressure readings comparing limbs.

Take care


The New Me

Change can be very difficult. Here are some random tips.

It’s a dangerous place when you start to see people and yourself for who you are.
Protect yourself.
Don’t go chasing windmills. Choose only the battles you know you can win.
Step away from the rest.
Be comfortable with saying no!
Step back from situations – think of yourself as a journalist – how would I report the situation
Notice your body – where are you feeling the tension
When people are being negative = do the 5 grounding technique
Practice using the body to calm the mind

Be curious – not judgmental – about yourself and others.
You may come across as a little standoffish when you are backing off, but you are protecting yourself.

When you use your voice, and this is perhaps new to you, criticizing other people, you may come off to others as rude because they are used to you being a people pleaser and not rocking the boat.

Balance – PEOPLE PLEASERS have a very difficult life. Now is the time to put yourself first

Where should I spend my energy – Do I want to spend my energy worrying about what others think of me?

Emotions too intense to tolerate? Usually you have been triggered. 

When the reaction is overboard or out of proportion to the situation, perhaps you have been triggered. 

Take care